Wednesday, October 18, 2006

And then the vet called...

To give me the results of Pixel's assorted blood and urine tests.

His kidneys and liver are good, considering that he already has kidney problems for which we already have him on Science Diet k/d. However...(as always), he has lost at least a pound since last year. He's at 9 lb 3 oz now. He isn't eating a whole lot, he's even stopped stealing the kitten's food. He has two new things to add to his list: he has a heart murmur and he's anemic. Turns out there are two kinds of anemia he might have: the expensive or the inexpensive kind.
  • Non-regenerative anemia may be due to the existing problems he already has: kidney disease and the fibrosarcoma (benign lumps on leg). His body has enough to deal with, it just isn't going to put out any extra effort to replace red blood cells.
  • Losing blood internally (not in his urine or intestines) which may be due to some mass growing on or in an internal organ.
It is only possible to determine which version of anemia he has and what course of treatment to take by having an abdominal ultrasound and an echocardiogram to check on the cause of the heart murmur. The vet also recommended we start "supportive care" by giving him the cat version of glucosamine and an appetite stimulant. We have until next Thursday to decide what we're going to do - that's when the traveling ultrasound group comes to the vet hospital.

I turned to Eric to fill him in on what the vet had said and then burst into tears.

I feel such guilt I can hardly encompass it. As she told me what my options were: expensive treatment or ignore it and make Pixel "comfortable", I kept feeling like I'm a terrible pet owner.

My choice comes down to money. Not whether it's the right thing to do, but whether we can afford it or not. The diagnosis alone will cost around $350. Keep in mind that that is the starting price. If they actually find a mass, we then have the secondary dilemma of what to do if there is something in there. Suddenly you have to weigh the cost of the diagnosis with the possibility that they will find something. Then you have to move on to the secondary guilt of what to do if they do find something. Do we then spend close to (I'm guessing) $1000 to get a 16 year old cat operated on to remove a mass? Will he get more years of life out of it if we do? How many more? What if we don't? How much sooner will he die if we just provide supportive care? Is he happy? Is he in pain? Is he ready to die? I'm not ready to put him to sleep and I'm really rather hoping that like Xerxes and Dart, he takes the decision from me.

Xerxes was 12 when she died, 4 years ago. She had cancer and we had money so we drove her to the vet hospital at CSU in Ft. Collins and gave her chemotherapy. It gave her another year of life and time for me to say goodbye. I made the call that morning to have the service come that would put her to sleep at my house (Did you know that there are services that will basically provide door to door euthanasia service? I had no idea. My friend Christine found out for me, for which I remain terribly grateful.) when she died, in my arms, in the backyard. I took her outside to feel the sun on her fur for the last time and she started dying. Or finished dying, depending on how you look at it.

I wailed and I keened with a dead cat in my lap until I could call my friend to come over and help me. I promise you that I am not exaggerating; Xerxes was my very first cat, I got her when she was only 2 months old, and I loved her dearly.

Dart died abruptly at 7, last February.

We had just noticed he was having a hard time breathing, had some sort of bloody sebum drawn out of the space around his lungs and ultrasounded him (looking for a mass) when he died two days after the ultrasound. One week after noticing he was sick, he was dead. He was possibly the sweetest cat I'll ever own.

I still miss them both.

Both cats went through the same process when they died. They made the caterwaul: it's a very real thing and can't ever be confused with the "lost cat" crying noise cats make sometimes when wandering around the house. It's the sort of sound that shakes you to the core. It is an awful thing and it is final. After that, they go into death throes and then they make the "death rattle" sound in their throats. And as awful as that is to see in person, when it happens naturally, somehow the thought of causing it to happen to Pixel is more than I can bear.

In neither case did I have to question if I would give them treatment. I just did because we had the money to do so. Now, here I am debating whether we can afford it or not.

I know some of you are thinking: "It's just a cat." And you're right: it is just a cat. However it's just my cat. A cat I've had for longer than I've been with Eric. It's still a serious decision to make and is emotionally wrenching for me. I have to weigh the cost of treatment against the potential gain in years of life. And as Dart showed us, it's possible that Pixel could either die on the operating table or immediately after treatment.

I have a responsibility to my pets, just as I do to my child and husband. I chose to make them part of my household. I have to take care of them because they cannot take care of themselves (like children, not like Eric). They don't even have the benefit of refusing care or telling us what they want or need, we just have to guess. We have to figure out who we're doing this for, the pet or the owner, and then we have deal with the fallout from any decisions made. Longevity versus quality of life.

The crazy thing is that all of these same issues for my cat are identical to what we go through for family in the same situation and clearly even more emotionally draining. I can only hope that I never have to make the choice between family care and finances. It is yet another reason that I believe we need universal healthcare in this country. Otherwise we're just saying as a nation, that it's perfectly fine if poor people die but let's save all the rich ones. That's just not right.

It's also why I believe in the right to request euthanasia. If it's "good enough" for our pets to "put them out of their misery", why wouldn't it be good enough for our family members? Especially if they ask it of you.

Do not resuscitate orders.

Living wills.

Pixel doesn't have one, so I have to choose for him. Am I strong enough?

1 comment:

Scylla said...

Oh honey. There is nothing trivial about the decision you have to make, and no one should diminish your pain by telling you your loved one is "just a pet."

As a life long cat lover, I have lost pets to a variety of different dieseases. The biggest question to ask yourself when determining a course of treatment is... what is best for your cat.

Is massive surgery good for a 16 year old cat? If you have a vet you can trust, ask them, what is the kindest thing I can do for my pet.

When my cat Countessa was ill, we went to see if we could help her. The vet described several courses of treatment for her, and then gave me an amazing gift. She told me all the courses of treatment would prolong my kitty's life, for me. She explained that they might not make her feel better, they might increase her pain, etc. It had never before occured to me that the kindest thing I could do was let go. She was about 16 years old, and had been with me since I was a child. It was a really hard decision, and I still miss her, but it helped to have an honest assessment of the effects of the treatment on my cat, rather than simply the options.

If you can get an honest assessment from your vet, do so.

As for the money. It sucks a lot. However, you and Eric are amazing people, with great capabilities. I know you will choose what you need to choose based on your hearts, and will work out the money afterwards. You will be successful at it too.

I love you all, pet Pixel for me please.

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